AB1566-HPR SHIFTING THE MINDSET: USING A HEALTH COACHING APPROACH FOR HEALTH PROMOTING CONSULTATION IN ADOLESCENT RHEUMATOLOGY
Authors: A. Bouraoui, P. Newman, C. Fisher, S. Mavrommatis, A. Mcdowell, D. Sen
Journal: Annals of the Rheumatic Diseases (2022)

Background Juvenile rheumatic diseases have a significant negative impact on health early in life which may affect later health outcomes. The Adolescent and Young Adult Rheumatology Department (AYAD) at University College London Hospitals (UCLH) looks after over 2,000 young people with a variety of rheumatological conditions and provides developmentally appropriate interdisciplinary (ID) approach to healthcare. Health coaching (HC) is “a behavioural intervention that facilitates participants in establishing and attaining health promoting goals in order to change lifestyle-related behaviour, with the intent of reducing health risks, improving self-management of chronic conditions, and increasing health related quality of life”.[1] Evidence shows that health coaching can improve health related behaviours including medication adherence, patient activation, and use of healthcare resources. [2-4] Objectives The aim of this project is to enable young people attending the AYAD to establish and achieve their own health-promoting goals and thereby change behaviour and increase confidence in self-management. As a first stage the aim was to develop health coaching capabilities within our ID Team by March 2022. Methods The strategy to deliver this project included commissioning a recognised core skills health coaching course for multidisciplinary team (MDT) members. Pre and post course surveys were completed by participants. Results All the AYA team members comprising 3 physiotherapists, 2 nurse specialists, a transition pathway coordinator, 4 consultants and 2 senior registrars took part in the health coaching workshops. A pre course survey (10/ 12 responded) revealed that 70% of MDT members felt their consultations focused solely on young people’s medical/clinical care. 80% reported they discuss lifestyle choices such as sleep, and weight management. 40 % felt that their consultation times were long enough to discuss resources that would support long-term management. 30% reported they felt effective in facilitating Young people and their families to self-manage and/or had sufficient health coaching awareness to facilitate behaviour change. The course was delivered over 2 separate days, one week apart, and included educational material, presentations, group discussion and skills development delivered in a coaching style. A post course survey (11/12 responses) demonstrated 100% of participants were satisfied with the course content, delivery, facilitation and opportunities to work and learn with colleagues, and felt that the skills were applicable to their work. They reported that the skills learned could be applied beyond healthcare, for example, with colleagues or in leadership roles, the course helped to raise self-awareness of behaviours that can negatively and positively impact patient and family engagement in their care, and that using some techniques and small changes to practice could potentially have a big impact on quality of care and outcomes as well as patient and staff experience. Conclusion Health coaching skills were considered as a useful tool by all AYAD team members. Skills gained on the course were considered useful in managing young people and applicable in settings beyond clinical care. The next stage of this project will include embedding the techniques learned into clinical practice and measuring qualitative and quantitative outcomes over time References [1]van Ryn, M., &amp; Heaney, C. A. (1997). Developing effective helping relationships in health education practice. Health Education &amp; Behavior, 24 (6), 683–702 [2] https://www.health.org.uk/publications/reducing-emergency-admissions-unlocking-the-potential-of-people-to-better-manage-their-long-term-conditions [3]Newman P, McDowell A, Life changing conversations: clinicians experience of health coaching in the east of England, 3-2-147 Future Hosp J June 1, 2016 [4] https://www.england.nhs.uk/wp-content/uploads/2020/03/health-coaching-implementation-and-quality-summary-guide.pdf Disclosure of Interests None declared